U.S. patent number 10,166,051 [Application Number 14/554,960] was granted by the patent office on 2019-01-01 for bone plate system.
This patent grant is currently assigned to Pioneer Surgical Technology, Inc.. The grantee listed for this patent is Pioneer Surgical Technology, Inc.. Invention is credited to Brad Fredin, Matthew P. Gephart, Brian P. Janowski, Francis J. Korhonen, Joseph Mohar, Lawrence Mosca, Scott Perrow, Matthew Songer.
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United States Patent |
10,166,051 |
Perrow , et al. |
January 1, 2019 |
Bone plate system
Abstract
A bone plate system having a retainer for resisting back-out of
a bone anchor from a throughbore of a bone plate is provided. In
one aspect, a bone plate system having a resilient retainer
disposed in a bone plate throughbore with a pair of elongate arm
portions of the resilient retainer extending along opposite sides
of the throughbore. In another aspect, a bone plate system having a
resilient retainer with a pair of elongate interference portions
completely exposed in the throughbore and spaced from each other
across the throughbore to retain a head of a bone anchor received
in the throughbore. In addition, a bone plate system having a
resilient retainer with a pair of opposite end portions disposed
within a groove of a throughbore wall such that a bone anchor may
be inserted into the throughbore without contacting either of the
opposite end portions of the retainer.
Inventors: |
Perrow; Scott (Ishpeming,
MI), Mohar; Joseph (Marquette, MI), Mosca; Lawrence
(Marquette, MI), Gephart; Matthew P. (Marquette, MI),
Janowski; Brian P. (Marquette, MI), Fredin; Brad (Cedar
Park, TX), Korhonen; Francis J. (Negaunee, MI), Songer;
Matthew (Marquette, MI) |
Applicant: |
Name |
City |
State |
Country |
Type |
Pioneer Surgical Technology, Inc. |
Marquette |
MI |
US |
|
|
Assignee: |
Pioneer Surgical Technology,
Inc. (Marquette, MI)
|
Family
ID: |
45807436 |
Appl.
No.: |
14/554,960 |
Filed: |
November 26, 2014 |
Prior Publication Data
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Document
Identifier |
Publication Date |
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US 20150150609 A1 |
Jun 4, 2015 |
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Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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13069354 |
Mar 22, 2011 |
8900277 |
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11259714 |
Mar 22, 2011 |
7909859 |
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10973891 |
Jun 22, 2010 |
7740649 |
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60548140 |
Feb 26, 2004 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B
17/7059 (20130101); A61B 17/8047 (20130101); A61B
17/8042 (20130101); A61B 17/8605 (20130101); A61B
17/8033 (20130101) |
Current International
Class: |
A61B
17/80 (20060101); A61B 17/70 (20060101); A61B
17/86 (20060101) |
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1, Jan. 2004,Charlottesville, VA, USA, (5 pages). cited by
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|
Primary Examiner: Woodall; Nicholas
Attorney, Agent or Firm: Fitch, Even, Tabin & Flannery
LLP
Parent Case Text
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a continuation of U.S. patent application Ser.
No. 13/069,354, filed Mar. 22, 2011, titled "Bone Plate System",
which is a continuation-in-part of U.S. patent application Ser. No.
11/259,714, filed Oct. 26, 2005 and issued as U.S. Pat. No.
7,909,859 on Mar. 22, 2011, titled "Bone Plate System and Methods,"
which is a continuation-in-part of U.S. patent application Ser. No.
10/973,891, filed Oct. 26, 2004 and issued as U.S. Pat. No.
7,740,649 on Jun. 22, 2010, titled "Bone Plate System and Methods,"
which claims the benefit of U.S. Provisional Patent Application No.
60/548,140, filed Feb. 26, 2004, titled "Bone Plate System," the
entirety of which are all hereby incorporated by reference.
Claims
What is claimed is:
1. A bone plate system comprising: a bone plate; a throughbore of
the bone plate; a bone anchor having an enlarged head and a shank
depending therefrom, the bone anchor having a longitudinal axis
extending between the head and the shank, the head including a
rotary drive structure and an upwardly facing surface extending
around the rotary drive structure; a wall of the bone plate
extending about the throughbore for supporting the bone anchor head
in the throughbore, the bone plate wall and the bone anchor head
configured to permit the bone anchor to be inserted into and extend
obliquely in the throughbore with a raised portion of the upwardly
facing surface of the bone anchor head at one side of the
throughbore and a lowered portion of the upwardly facing surface of
the bone anchor head at or adjacent an opposite side of the
throughbore; a resilient retainer disposed in the throughbore; bone
plate engaging portions of the resilient retainer secured to the
bone plate at the opposite sides of the throughbore; a pair of
elongate arm portions of the resilient retainer connecting the bone
plate engaging portions and extending in the throughbore spaced
apart from each other, the elongate arm portions being configured
to allow the raised portion of the upwardly facing surface of the
bone anchor head at the one side of the throughbore to be above the
bone plate engaging portion at the one side of the throughbore with
the bone anchor head seated in the throughbore; interference
portions of the elongate arm portions extending in the throughbore
intermediate the bone plate engaging portions and being configured
to allow the interference portions to be above the lowered portion
of the upwardly facing surface of the bone anchor head so that the
interference portions are in interference with the lowered portion
of the upwardly facing surface of the bone anchor head to resist
back-out of the bone anchor from the throughbore; and the bone
anchor head and the retainer interference portions are configured
so that no portion of the bone anchor head extends laterally over
the retainer interference portions with the bone anchor inserted
into and extending obliquely in the throughbore and the
interference portions extending above the lowered portion of the
upwardly facing surface of the bone anchor head.
2. The bone plate system of claim 1 wherein the elongate arm
portions of the resilient retainer include transition portions
extending transverse to the interference portions that provide
clearance for the bone anchor head to extend obliquely in the
throughbore.
3. The bone plate system of claim 1 wherein the interference
portions extend in the throughbore spaced from the bore wall so
that the interference portions are completely exposed in the
throughbore.
4. The bone plate system of claim 1 wherein the upwardly facing
surface has an annular configuration and the bone anchor head
includes a lower curved surface and a radially outer corner
junction between the annular upwardly facing surface and the lower
curved surface; and the raised portion of the bone anchor head
includes a portion of the annular upwardly facing surface at the
outer corner junction of the bone anchor head.
5. The bone plate system of claim 4 wherein the lowered portion of
the bone anchor head includes a portion of the upwardly facing
surface of the bone anchor head.
6. The bone plate system of claim 1 wherein the bone plate wall
includes a throughbore seat for engaging the bone anchor head, the
seat having a narrow portion disposed at the one side of the
throughbore and a wide portion disposed at or adjacent the opposite
side of the throughbore.
7. The bone plate system of claim 1 wherein the bone plate wall
includes a recess that opens to the throughbore and the bone plate
engaging portions of the resilient retainer are disposed in the
recess at the opposite sides of the throughbore.
8. The bone plate system of claim 1 wherein the resilient retainer
has a generally looped configuration about the throughbore with a
predetermined length about the throughbore and a transverse
cross-sectional configuration that is substantially uniform along
at least a majority of the length of the retainer.
9. The bone plate system of claim 8 wherein the transverse
cross-sectional configuration of the resilient retainer is
substantially uniform along the entire length of the retainer.
10. A bone plate system comprising: a bone plate; a plurality of
throughbores of the bone plate; a plurality of bone anchors for
extending through respective throughbores; one of the bone anchors
having a head portion for being received in one of the
throughbores, a shank portion depending from the head portion, and
a longitudinal axis; a rotary drive structure of the bone anchor
head portion; a substantially annular upwardly facing surface of
the bone anchor head portion extending about the rotary drive
structure; the bone anchor head portion having no portion thereof
that extends laterally over the annular upwardly facing surface; a
resilient retainer associated with the one throughbore; an elongate
body of the resilient retainer extending about the one throughbore;
an intermediate curved portion of the retainer body having a
predetermined curvature; and curved retention portions of the
retainer body with the intermediate curved portion intermediate the
curved retention portions along the retainer body, the curved
retention portions having different curvatures than the curvature
of the intermediate curved portion and being configured to shift
apart to permit the head portion of the one bone anchor to be
advanced into the one throughbore and shift back toward each other
above the annular upwardly facing surface of the bone anchor head
portion to inhibit back out of the one bone anchor from the one
throughbore.
11. The bone plate system of claim 10 wherein the curved retention
portions of the retainer body have a more gradual curvature than
the curvature of the intermediate curved portion.
12. The bone plate system of claim 10 wherein the retainer body
includes another intermediate curved portion intermediate the
curved retainer portions along the retainer body and the
intermediate curved portions have different curvatures from each
other and the curved retention portions of the retainer body.
13. The bone plate system of claim 10 wherein the bone plate
includes a bore wall extending about the one throughbore and a
recess in the wall extending outwardly from the throughbore; and
the elongate body of the resilient retainer has a cross-sectional
configuration transverse to a length thereof and the intermediate
curved portion of the retainer body is disposed entirely within the
recess outwardly from the throughbore for the entirety of the
cross-section of the intermediate curved portion.
14. The bone plate system of claim 10 wherein the bone anchor head
portion includes a curved lower surface and a radially outer corner
junction between the annular upwardly facing surface and the lower
curved surface.
15. The bone plate system of claim 10 wherein the annular upwardly
facing surface of the bone anchor head is flat.
16. The bone plate system of claim 10 wherein the bone plate
includes a bore wall extending about the one throughbore and the
curved retention portions of the retainer body are spaced from the
bore wall to be completely exposed in the throughbore.
17. The bone plate system of claim 10 wherein the curved retention
portions both have one of a concave curvature and a convex
curvature and the retainer body includes curved portions adjacent
the curved retention portions along the retainer body having the
other of the concave curvature and the convex curvature.
18. The bone plate system of claim 10 wherein the curved retention
portions have the same curvatures.
19. The bone plate system of claim 10 wherein the elongate body of
the resilient retainer has an outer perimeter and the intermediate
curved portion and the curved retention portions extend along the
perimeter at different positions along the perimeter.
Description
FIELD OF THE INVENTION
The invention relates to bone plate systems and, more particularly,
to bone plate systems having retention systems that resist bone
anchor back out from throughbores of the bone plate.
BACKGROUND OF THE INVENTION
There are presently many different types of bone plate systems for
securing bones, bone fragments, and/or implants in relative
position so that the bones or bone fragments may fuse or heal. A
shortcoming of some bone plates is the backing out or loosening of
bone anchors that secure the bone plate to one or more bones. If
the bone anchors loosen, the bones may not be properly secured and
may move relative to each other. This may compromise the ability to
achieve optimal bone fusion and bone alignment, may lead to loss of
graft material, and may cause damage or loss of bone. When the bone
plate is a dynamic or dynamized bone plate, such that at least some
screws may move relative to the bone plate, these issues may be
further compounded or exacerbated by a screw backing out.
One approach to limiting back-out of a bone anchor from a bone
plate is disclosed in U.S. Pat. No. 6,599,290 to Bailey et al.,
which utilizes a locking ring positioned within a throughbore. The
bone anchor has a head with a tapered lower segment that
resiliently expands the locking ring as the bone anchor head passes
through a central opening of the locking ring and into the
throughbore. The locking ring resiliently retracts over the top of
the bone anchor once the head is seated within the throughbore and
resists back-out of the bone anchor from the throughbore. The
locking ring, however, has a flange extending above the upper
surface of the bone plate that may contact and irritate adjacent
tissues.
U.S. Patent Application Publication No. 2005/0049593 to Duong et
al. discloses another approach to limiting back-out of a bone
anchor from a throughbore. Specifically, Duong et al. disclose an
omega-shaped resilient clip that snaps into a perimetral groove on
a head of the bone anchor to resist back-out of the bone anchor
from the throughbore. The bone anchor head includes upper and lower
radially enlarged sections that define the perimetral groove
therebetween. The bone plate is relatively thick to permit both of
the radially enlarged sections of the bone anchor head to be
received within the throughbore. Further, the upper radially
enlarged section of the bone anchor head interferes with arms of
the resilient clip and limits pivoting of the bone anchor when the
clip is engaged with the perimetral groove on the bone anchor
head.
SUMMARY OF THE INVENTION
In one form of the invention, a bone plate system is provided
having a resilient retainer disposed in a bone plate throughbore to
resist back-out of a bone anchor from the throughbore. The
throughbore has a predetermined axial length along a bone plate
longitudinal axis and a pair of opposite axial end portions along
the axial length of the throughbore. The resilient retainer has a
pair of elongate arm portions extending along opposite sides of the
throughbore and interference portions of the elongate arm portions
disposed in the throughbore to be adjacent or in a predetermined
one of the axial end portions of the throughbore. The resilient
retainer also has bone plate engaging portions at the other axial
end portion of the throughbore. The other axial end portion of the
throughbore and an enlarged head of the bone anchor are configured
and sized relative to each other to allow the bone anchor to extend
obliquely in the throughbore with a raised portion of the bone
anchor head generally level with the retainer bone plate engaging
portions at the other axial end portion of the throughbore and a
lowered portion of the bone anchor head disposed below the retainer
interference portions in the throughbore. In this manner, the
thickness of the bone plate may be reduced as the entirety of
enlarged head of the bone anchor need not be disposed below the
interference portions of the resilient retainer when the bone
anchor extends obliquely in the bore. In one embodiment, the
throughbore has a seat with a wide portion disposed below the
interference portions and a narrow portion axially offset from the
interference portions in the throughbore. The seat includes a wall
extending below the narrow portion of the seat for engaging a shank
of the bone anchor and limiting the bone anchor to a predetermined
maximum oblique angle relative to a central bore axis. With the
enlarged head of the bone anchor received in the bore and the bone
anchor extending at the maximum oblique angle, the narrow portion
of the throughbore seat positions the raised portion of the
enlarged head at a predetermined height within the throughbore
where the raised portion of the head remains below a top surface of
the bone plate. In this manner, the raised portion of the enlarged
head avoids interfering with adjacent tissues even when the bone
anchor is extending at the maximum oblique angle in the bore.
Further, the thickness of the bone plate may be minimized for a
given bone anchor and desired maximum oblique insertion angle
without compromising or reducing back-out resistance provided by
the interference portions of the resilient retainer.
In another form of the invention, a bone plate system is provided
having a bone plate with a plurality of throughbores and bore walls
extending about the throughbores. The bone plate system has a
resilient retainer received in each of the throughbores to resist
back-out of bone anchors from the throughbores. Each resilient
retainer has a pair of elongate interference portions disposed in
an associated throughbore that extend along either side of the
throughbore spaced from the bore wall thereof to be completely
exposed in the throughbore and spaced from each other across the
throughbore to retain a head portion of a bone anchor received in
the throughbore. In this manner, the interference portions of the
resilient retainers can shift to a deflected position in the
associated throughbore as a bone anchor is driven into the
throughbore and resiliently shift back to an interference position
above the bone anchor head portion once the head portion is seated
in the throughbore. Further, the spacing between the interference
portions and the bore wall provides clearance for the interference
portions to deflect out of the way of the bone anchor as the bone
anchor is inserted into the throughbore. In one embodiment, the
resilient retainers include bone plate engaging portions configured
for being held in the bone plate and transition portions extending
between the bone plate engaging portions and the interference
portions. The transition portions extend along opposite sides of a
raised portion of an associated bone anchor head portion when the
head portion is received in the throughbore and the bone anchor
extends obliquely to a central axis of the throughbore. Because the
transition portions of the resilient retainer are positioned out of
the way of the raised portion, the interference portions may
resiliently shift back to the interference position above the head
portion without contact between the transition portions and the
raised portion of the bone anchor head portion restricting movement
of the interference portions.
In one aspect of the invention, a bone plate system is provided
having a resilient retainer disposed within a throughbore to resist
bone anchor back-out therefrom. The retainer has a pair of
interference portions that are spaced from each other and extend
along either side of the throughbore to be in interference with a
head portion of the bone anchor. The bone plate has a bore wall
extending about the throughbore and a groove in the bore wall which
opens to the throughbore. The resilient retainer has a pair of
opposite end portions disposed at opposite ends of the throughbore
with the opposite end portions of the retainer disposed in the
groove. In this manner, the bone anchor may be inserted into the
throughbore without the bone anchor interfering or snagging on the
end portions of the resilient retainer since the end portions are
received in the groove radially recessed in the bore wall. In one
embodiment, the resilient retainer includes transition portions
disposed between the interference portions and one of the end
portions of the retainer. The transition portions are spaced from
the one end portion to permit a raised portion of the seated bone
anchor head portion to extend between the transition portions and
the one end portion of the retainer when the bone anchor head
portion is received in the throughbore and the bone anchor extends
obliquely in the throughbore. In this manner, the transition
portions and the one end portion of the retainer generally extend
around the raised portion of the seated bone anchor head portion
such that the transition portions and the one end portion are out
of the way of the raised portion and avoid restricting the bone
anchor from extending at oblique angles within the throughbore.
Further, the interference portions are free to resiliently shift
back to an interference position above the seated head portion to
resist back-out of the bone anchor without contact between the
transition portions and/or the one end portion inhibiting movement
of the interference portions.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a perspective view of a bone plate system in accordance
with one form of the present invention showing a bone plate
including a plurality of throughbores and resilient retainers for
resisting back-out of bone anchors from the throughbores;
FIG. 2 is an enlarged, plan view of one of the throughbores of the
bone plate system of FIG. 1 showing arms of the retainer extending
along the throughbore and ends of the resilient retainer in
phantom;
FIG. 3 is a cross-sectional view of the bone plate system of FIG. 1
taken across line 3-3 in FIG. 1 showing one of the bone anchors
seated in one of the throughbores;
FIG. 4 is a fragmented cross-sectional view of the bone plate
system of FIG. 1 similar to FIG. 3 showing a portion of a resilient
retainer extending over the bone anchor to resist back-out;
FIG. 5 is a enlarged view similar to FIG. 4 with the retainer and
the bone anchor removed to show a groove in the bore wall;
FIG. 6 is a cross-sectional view of the bone plate system of FIG. 1
similar to FIG. 3 with the bone anchor removed to show a profile of
a throughbore seat;
FIG. 7 is a cross-sectional view of the bone plate system of FIG. 1
similar to FIG. 6 showing the bone anchor seated in the throughbore
at a maximum angle toward an adjacent end of the bone plate and, in
phantom, the bone anchor seated in the throughbore at a maximum
angle toward a center of the bone plate;
FIG. 8 is a cross-sectional view of the bone plate system of FIG. 1
taken along line 8-8 in FIG. 1 with the associated bone anchor
removed to show a profile of a throughbore seat;
FIG. 9 is a cross-sectional view of the bone plate system of FIG. 1
similar to FIG. 8 showing the bone anchor seated in the throughbore
at one end of the throughbore at a maximum angle toward an adjacent
end of the bone plate and, in phantom, the bone anchor seated at
the other end of the throughbore at a maximum angle toward the
center of the bone plate;
FIG. 10 is a cross-sectional view of the bone plate system of FIG.
1 taken along line 10-10 in FIG. 1 showing one of the throughbores
with the associated retainer and bone anchor removed;
FIG. 11 is a cross-sectional view of the bone plate system of FIG.
1 similar to FIG. 10 showing the retainer positioned within the
throughbore;
FIG. 12 is a perspective view of a bone anchor of the bone plate
system of FIG. 1 showing a tool-receiving bore of the bone
anchor;
FIG. 13A is a side elevational view of the bone anchor of FIG. 12
showing an outer profile of the bone anchor head;
FIG. 13B is a side elevational view of another bone anchor showing
an outer profile of the bone anchor head;
FIG. 14A is a plan view of a retainer for a dynamized bore of the
bone plate system of FIG. 1 showing the retainer disposed above an
associated bone anchor shown in phantom as the bone anchor travels
along the dynamized bore;
FIG. 14B is a plan view of the retainer of FIG. 14A showing the
retainer in an expanded configuration;
FIG. 15 is a plan view of a retainer for a non-dynamized bore of
the bone plate system of FIG. 1 showing the retainer disposed above
an associated bone anchor shown in phantom;
FIG. 16 is a perspective view of a bone plate system in accordance
with another form of the present invention having several bone
anchors and associated retainers removed from the bone plate;
FIG. 17 is a plan view of a retainer of the bone plate system of
FIG. 16;
FIG. 18 is an enlarged cross-sectional view of the bone plate
system of FIG. 16 taken along line 18-18 in FIG. 16 showing a bone
anchor seated within an associated throughbore;
FIG. 19 is an enlarged cross-sectional perspective view of the bone
plate system of FIG. 16 similar to FIG. 18 showing a portion of the
resilient retainer extending over the bone anchor to resist
back-out;
FIG. 20 is a cross-sectional view of the bone plate system of FIG.
16 taken along line 20-20 in FIG. 16 showing a throughbore with the
associated retainer and bone anchor removed;
FIG. 21 is a cross-sectional view of the bone plate system of FIG.
16 similar to FIG. 20 showing the retainer positioned within the
throughbore;
FIG. 22 is a perspective view of a bone plate system in accordance
with another form of the present invention having all but one bone
anchor removed from the bone plate;
FIG. 23 is a cross-sectional view of the bone plate system of FIG.
22 taken along line 23-23 in FIG. 22 showing a throughbore with an
associated retainer and bone anchor removed;
FIG. 24 is a cross-sectional view of the bone plate system of FIG.
22 similar to FIG. 23 showing the retainer positioned within the
throughbore;
FIG. 25 is a plan view of a retainer of the bone plate system of
FIG. 22; and
FIG. 26 is a side elevational view of a retainer of the bone plate
system of FIG. 22.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
In FIGS. 1-15, a bone plate system 10 in accordance with one form
of the present invention is shown. The bone plate system 10
includes a bone plate 12 having a throughbore 52 for receiving a
bone anchor 56 and a retainer 60 disposed in the throughbore 52 for
resisting back-out of the bone anchor 56, as shown in FIG. 2. The
retainer 60 has interference portions 94, 95 that deflect apart as
the bone anchor 56 is inserted into the throughbore 52 and
resiliently return to an interference position above an enlarged
head 76 of the bone anchor 56 once the head 76 is seated within the
throughbore 52 to resist back-out of the bone anchor 56 from the
throughbore 52. The retainer 60 has ends 150, 160 held within the
bone plate 12 and the interference portions 94, 95 extend between
the ends 150, 160 along opposite sides of the throughbore 52. The
throughbore 52 has a length along an axis 31 and a pair of opposite
axial end portions 33, 35. The axial portion 35 and the bone anchor
head 76 are sized relative to each other to allow the bone anchor
56 to extend obliquely in the throughbore 52 with a raised portion
107 of the bone anchor head 76 extending level with or above the
retainer 60 in the axial portion 35 of the throughbore 52 while a
lowered portion 109 of the bone anchor head 76 is disposed below
the interference portions 94, 95 in the axial portion 33 of the
throughbore 52. Further, transverse portions 103, 105 of the
retainer 60 extend away from the interference portions 94, 95 to
provide room for the raised portion 107 of the bone anchor head 76
when the bone anchor head 76 is seated in the bore 52 and the bone
anchor 56 extends obliquely in the bore 52. By allowing the raised
portion 107 of the bone anchor head 76 to extend to a height level
with or above the retainer 60, the thickness of the bone plate 12
can be reduced since the entirety of the bone anchor head 76 does
not need to be disposed below the retainer 60.
More specifically, the bone anchor 56 may be driven into the
throughbore 52 at an oblique angle .alpha. relative to a bore
central axis 72 until the head 76 of the bone anchor 56 engages a
seat 80 of the throughbore 52, as shown in FIG. 3. The seat 80 has
a narrow or shallow portion 81 and a wide or deep portion 83 that
engage the bone anchor head 76, as shown in FIG. 5. The shallow
portion 81 positions the raised portion 107 higher within the bore
52 than the wide portion 83 positions the lowered portion 109 such
that the raised portion 107 extends above the retainer 60, as shown
in FIG. 4. The lowered portion 109, however, extends below the
interference portions 94, 95 such that the resilient retainer 60
still resists back-out of the bone anchor 56 via engagement between
the interference portions 94, 95 and the lowered portion 109 even
with the raised portion 107 extending above the retainer 60.
Further, the transverse portions 103, 105 of the retainer bow
outwardly apart from one another and are disposed on either side of
the raised portion 107 and out of the way of the bone anchor head
76 seated in the throughbore 52. In this manner, the interference
portions 94, 95 can resiliently return to their interference
position once the bone anchor head 76 is seated within the bore 52
without contact between the transverse portions 103, 105 and the
bone anchor head 76 limiting movement of the interference portions
94, 95.
Returning to FIG. 1, the bone plate 12 is preferably made of
biocompatible materials, such as titanium, titanium alloy, or
stainless steel. The bone plate 12 has a pair of upper dynamized
throughbores 14, 16 configured to receive bone anchors 18, 20
therein and permit the anchors 18, 20 to translate within the bores
14, 16 along the length of the bone plate 12. Resilient retainers
22, 24 are positioned within the bores 14, 16 and resist back-out
of bone anchors 18, 20 as the anchors 18, 20 translate along the
bores 14, 16. The bone plate 12 also includes a pair of
intermediate dynamized throughbores 30, 32 that receive bone
anchors 34, 36 and which have a length that is less than the length
of the upper dynamized bores 14, 16. Resilient retainers 38, 40
restrict back-out of the anchors 34, 36 along the length of the
throughbores 30, 32 in a manner similar to the retainers 22, 24.
Bone plate 12 further comprises a pair of lower non-dynamized
throughbores 50, 52 that do not permit translation of bone anchors
54, 56. Instead, the bone anchors 54, 56 are fixed against
translation and retainers 58, 60 resist back-out of the bone
anchors 54, 56 from the throughbores 50, 52. The throughbores 14,
16, 30, 32, 50, and 52 may all generally permit polyaxial insertion
to provide flexibility during installation of the bone plate system
10. The bone plate 12 has windows 62 and openings 64 sized to
receive portions of a tool (not shown) for positioning the bone
plate 12 during surgery.
As shown in FIG. 3, the bone anchor 56 is driven into the lower
non-dynamized throughbore 52 in an oblique direction 70 at an
oblique angle .alpha. relative to the bore central axis 72 to drive
a shank 74 of the bone anchor 56 into a bone (not shown) disposed
below the bone plate 12. Driving the bone anchor 56 in direction 70
also engages the head 76 of the bone anchor 56 against the seat 80
of the bone plate 12 and fixes the bone plate 12 to the bone. In
the lower non-dynamized throughbores 50, 52, the bone plate system
10 preferably provides a bone anchor insertion angle .alpha.
between the bore central axis 72 and a longitudinal axis 78 of the
bone anchor 56 of up to approximately 20.degree. along the length
of the bone plate 12. In the illustrated embodiment, the remaining
bores 14, 16, 30, 32 provide a smaller range of bone anchor
insertion angles, as will be discussed in greater detail below.
As shown in FIG. 4, the bone plate 12 has a retention structure for
holding the retainer 60 in the bore 52 of the bone plate 12. For
this purpose, a bore wall 90 extends about the bore 52 with a
groove 92 therein sized to receive portions of the retainer 60. As
the bone anchor 56 is inserted into the bore 52 in direction 70,
the shank 74 and the head 76 cammingly engage interference portions
94, 95 (see FIG. 11) of the retainer 60 so as to push the retainer
interference portions radially outward in radially outward
directions 97, 99 toward the bore wall 90. When the bone anchor
head 76 is seated within the bore 52, the interference portions 94,
95 resiliently return in radially inward directions 100, 101 so as
to extend over the bone anchor head 76 in interference therewith.
The interference portions 94, 95 extend over the anchor head 76 in
overlapping relation so as to cross annular surface 102 of the bone
anchor 56 such that the interference portions 94, 95 restrict
back-out of the bone anchor 56. As illustrated, a generally
elliptical opening 71 opens into the bore 52 and the interference
portions 94, 95 may extend across the opening 71 in a manner
similar to chords of an ellipse.
The transverse portions 103, 105 extend away from the interference
portions 94, 95 and into the groove 92 (see FIG. 11). As the bone
anchor 56 enters the throughbore 52 at an angle .alpha., the shank
74 and/or the head 76 may cam the interference portions 94, 95
and/or the transverse portions 103, 105 toward the groove 92 and
out of the path of the bone anchor 56, as shown in FIG. 4. The
transverse portion 103 is spaced radially outward from the raised
portion 107 when the bone anchor head 76 is seated at angle .alpha.
within the throughbore 52. The interference portions 94, 95 are
disposed above at least a portion of the bone anchor head annular
surface 102 to be in interference therewith and restrict back-out
of the bone anchor 56 from the throughbore 52.
With reference to FIGS. 4 and 5, the bore wall 90 includes inwardly
extending upper and lower sections 110, 112 that extend around the
bore 52 and define the groove 92 therebetween. The seat 80 includes
a seating surface 114 that is complimentary to a curved surface 96
of the bone anchor head 76 and permits the bone anchor head 76 to
seat within the bore 52 at a range of bone anchor insertion angles.
The engagement between the curved seating surface 114 and the bone
anchor head lower surface 96 permits the bone anchor 56 to be
polyaxially driven into and seated in the throughbore 52. Further,
the engagement between the curved surfaces 96, 114 may permit
relative movement therebetween so the bone anchor 56 can rotate
relative the bone plate 12 and permit a bone engaged with the
anchor 56 to subside.
As shown in FIG. 5, the seat 80 includes a collar portion 116 that
generally generally defines a lower portion of the bore 52 and
engages the bone anchor shank 74 to restrict an insertion angle
.alpha. of the bone anchor 56 in the cephalad/caudal (toward the
head or feet) plane to a range of approximately -10.degree. to
approximately +20.degree. from the bore central axis 72. The collar
portion 116 also restricts an insertion angle .beta. of the bone
anchor 56 in the medial/lateral (toward the center or side) plane
to a range of approximately -5.degree. to approximately +5.degree.
from the bore central axis 72.
The collar portion 116 includes substantially vertical walls 117,
118, 120 that engage the bone anchor shank 74 and neck 98 and
restrict the angle at which the bone anchor 56 may extend within
the bore 52. For example, with reference to FIGS. 6 and 7, driving
the anchor 56 into the bore 52 at angle .alpha. seats the lower
curved surface 96 of the bone anchor head 76 upon both the narrow
portion 81 and the wide portion 83 of the seat 80. The seat 80 and
the lower curved surface 96 of the bone anchor head 76 preferably
have spherical profiles with a substantially similar radius of
curvature to permit the bone anchor 56 to engage the seat 80
throughout a range of insertion angles of the bone anchor 56.
The walls 118, 120 are radially recessed such that the walls 118,
120 provide clearance for the bone anchor shank 74 to extend at
oblique angles relative to the bore central axis 72 in the
cephalad/caudal and medial/lateral planes. As shown in FIG. 7, the
wall 120 has a lower portion 121 that engages the bone anchor shank
74 and/or neck 98 and restricts the bone anchor 56 from being
inserted into the bore 52 at an insertion angle greater than
maximum oblique angle .alpha.. Once the bone anchor head 76 is
engaged with the seat 80, the walls 118, 120 also restrict rotation
of the anchor 56 in direction 123 beyond angle .alpha. to limit
post-operative rotation of the bone anchor 56. At the other end of
the bore 52, the wide portion 83 of the seat 80 extends radially
inward farther than the narrow portion 81 (see FIG. 10). As shown
by reference numeral 56' in FIG. 7, subsidence of the bone engaged
with bone anchor 56 may rotate the anchor 56 in direction 125 until
the anchor 56 extends at a maximum oblique angle .alpha.' relative
to the bore axis 72. The wide portion 83, and the clearance wall
117 extending therebelow, restrict rotation of the bone anchor 56
in direction 125 beyond the angle .alpha.' and thereby restrict
subsidence of a bone engaged with bone anchor 56. In the
illustrated form, angle .alpha. is approximately 20.degree. and
angle .alpha.' is approximately 10.degree..
Unlike the bore 52, the elongated bore 14 has similar maximum
oblique angles .delta., .delta.' between a longitudinal axis 133 of
the bone anchor 20 and a central bore axis 135 in the
cephalad/caudal plane, as shown in FIGS. 8 and 9. The bore 14 has a
seat 137 with a substantially uniform width around the bore 14. The
seat 137 has a lower wall 139 extending around the bore 14 for
engaging and restricting the bone anchor insertion angle beyond
angle .delta. and rotational subsidence of the bone anchor 20
beyond angle .delta.'. As is apparent, the seat 137 lacks radially
recessed walls, like the walls 118 and 120 of seat 80, which permit
the bone anchor 20 to extend at a greater angle in one direction
than in another direction along the length of the bone plate 12.
The seat 137 may include a relatively small cutout 143 that permits
the bone anchor 20 to extend at angle .delta. and compensates for
the curvature of the bone plate 12. Further, the seat 137 and the
lower wall 139 permits a raised portion 141 of the bone anchor 20
to be level with the bone plate engaging portions 219, 221 of the
retainer 22 and a lowered portion 145 of the bone anchor 20 to be
disposed below interference portions 226, 228 of the retainer 22
when the bone anchor 20 extends obliquely in the bore 14 (see FIGS.
8 and 9). In the illustrated form, angles .delta. and .delta.' are
both approximately 10.degree..
The bores 14, 16, 30, 32 each provide bone anchor insertion angles
in the range of approximately -10.degree. to approximately
+10.degree. in the cephalad/caudal plane and approximately
-5.degree. to approximately +5.degree. in the medial/lateral plane.
In an alternative form shown in FIG. 13B, the bone anchor head 76A
has an enlarged cylindrical section 199A rather than the curved
surface 96 and the bone plate seat 80 has a shape complimentary to
the cylindrical outer profile such that the bone anchor 56A is
restricted to seating within the throughbore 52 at a predetermined
angle, e.g., +10.degree. in the cephalad/caudal plane, and
+5.degree. in the medial/lateral plane. The complimentary shape of
the bone plate seat 80 also inhibits pivoting of the bone anchor
56A once the bone anchor 56A is engaged with the seat 80.
Turning to FIGS. 10 and 11, a cross-sectional view of the bore wall
90 surrounding the bore 52 is shown. The bore wall 90 includes
pairs of transverse end walls 130, 132, 134, and 136. The bore wall
90 also includes a pair of opposed side walls 138, 140 separated
from the transverse end walls 134, 136 by corners 142, 144. The
transverse end walls 130, 132, 134, 136 are disposed between the
inwardly extending sections 110, 112 (see FIG. 5) of the bore wall
90 and define a height of the groove 92. To position the retainer
60 within the groove 92, as shown in FIG. 11, the retainer 60 has
an open end portion 150 including a pair of spaced ends 152, 154
separated by a gap spacing 156. The spaced ends 152, 154 are
deflected toward each other to shift the retainer 60 to a collapsed
position before a closed end portion 160 of the retainer is
inserted into the bore 52 and positioned within the groove 92. The
open end portion 150 is inserted into the groove 92 and the spaced
ends 152, 154 are released. The spaced ends 152, 154 resiliently
expand apart to fix the retainer 60 within the groove 92. In a
preferred approach, the bone plate system 10 is preassembled with
the retainers disposed in respective throughbores.
With the retainer 60 in the groove 92, the spaced ends 152, 154
abut the transverse end walls 130, 132 and retainer straights 162,
164 abut the transverse end walls 134, 136, as shown in FIG. 11. In
one approach, the bone anchor 56 is inserted into the throughbore
52 and rotated in direction 166 to drive the bone anchor 56 into a
bone (not shown). Contact between the rotating bone anchor 56 and
the retainer 60 may cause the retainer 60 to tend to rotate in
direction 166. To resist this rotation, the retainer straight 164
engages the transverse extending wall 136 and a bend 168 of the
retainer 60 engages the corner 142 of the bore wall 90. Similarly,
if the bone anchor 56 is rotated in direction 170 to remove the
bone anchor 56 from the bone, the contact between the bone anchor
56 and the retainer 60 may cause the retainer 60 to tend to rotate
in direction 170. To resist this rotation, the retainer straight
162 engages the transverse end wall 134 and a bend 172 of the
retainer 60 engages the corner 144 of the bore wall 90. Further,
inserting the bone anchor 56 into the bore 52 causes the shank 74
and the head 76 to cam the interference portions 94, 95 radially
outward in directions 97, 99, as discussed above. This causes the
spaced ends 152, 154 of the retainer 60 to move in directions 178,
180 along the transverse end walls 130, 132.
Turning to FIGS. 12-13B, further details of the bone anchor 56 are
illustrated. Specifically, the head 76 includes a collar 190
comprising an annular wall 192 extending around a tool receiving
bore 194. The collar 190 includes threads 196 used to secure the
bone anchor 56 to a tool and a hex recess 198 for receiving a drive
portion of the tool. The annular wall 192 may have an outer
diameter 193 in the range of approximately 0.12 inches to
approximately 0.18 inches, preferably approximately 0.158 inches.
In one form, the outer diameter 193 is slightly larger than the
interference distance 230 of the retainer 22 (see FIG. 14A) when
the retainer 22 is disposed in the elongate throughbore 14 such
that the annular wall 192 of the bone anchor 20 slightly biases the
respective interference portions 226, 228 apart as the bone anchor
20 travels along the elongate bore 14. The curved surface 96 may
have a radius 200 in the range of approximately 0.11 inches to
approximately 0.16 inches, preferably 0.135 inches. The head 76 may
have a height 195 in the range of approximately 0.06 inches to
approximately 0.09 inches, preferably approximately 0.075 inches.
The bone plate 12, by contrast, may have a thickness adjacent the
throughbore 52 in the range of approximately 0.072 inches to
approximately 0.108 inches, preferably 0.09 inches. The head 76 may
have an outer diameter 197 in the range of approximately 0.17
inches to approximately 0.25 inches, preferably 0.218 inches. In an
alternative form, the head 76 lacks the annular wall 192 such that
the annular surface 192 generally defines the uppermost portion of
the head 76. The bone anchor 56 is preferably made from titanium,
but may be made of another biocompatible material such as titanium
alloy or stainless steel.
As shown in FIG. 13B, bone anchor 56A is similar to the bone anchor
56 except that the bone anchor 56 is a fixed angle screw as
discussed above. In this embodiment, the bone anchor 56A has an
annular wall 192A with an outer diameter 193A in the range of
approximately 0.12 inches to approximately 0.18 inches, preferably
0.158 inches. The head 76A has a height 195A in the range of
approximately 0.05 inches to approximately 0.09 inches, preferably
0.07 inches. Further, the head 76A has an outer diameter 197A in
the range of approximately 0.17 inches to approximately 0.25
inches, preferably 0.218 inches.
In FIGS. 14A and 15, the resilient retainer 22 for the dynamized
bore 14 and the resilient retainer 60 for the non-dynamized bore 52
are illustrated disposed above respective bone anchor heads 232, 76
(see FIG. 1) shown in phantom for clarity. The retainers 22, 60 are
shown in FIGS. 14A and 15 as they would appear when positioned
within respective bores 14, 52. The resilient retainers 22, 60 may
be larger than the respective bores 14, 52 such that the retainers
22, 60 are in a deflected configuration when positioned within the
bores 14, 52. For example, FIG. 14B illustrates the retainer 22 in
an expanded configuration when the retainer 22 is removed from the
bore 14. The retainer 22 has open end portion 218 open a greater
amount than when the retainer 22 is positioned within the
throughbore 14, as shown in FIG. 14A. The retainers 22, 60 are
preferably made by bending elongate Nitinol wires into the desired
retainer shape. The retainer 22, 60 may alternatively be made of
titanium, titanium alloy, stainless steel, or other biocompatible
materials.
The retainer 22 has a thin body 214 comprising a closed end portion
216 and an open end portion 218. A pair of bone plate engaging
portions 219, 221 extend away from the closed end portion 216 and
are separated from each other by a distance 233. The closed end
portion 216 and the bone plate engaging portions 219, 221 are
received within a groove of the throughbore 14 similar to the
groove 92 of the throughbore 52 and keep the retainer 22 within the
bore 14. A pair of transverse portions 220, 222 extend inward from
the bone plate engaging portions 219, 221 and are spaced from each
other by a distance 224 sized to accommodate a raised portion of a
bone anchor head 232 (see FIG. 1) between the transverse portions
220, 222 and the closed end 216 (see FIG. 9) of the retainer 22.
The retainer 22 includes a pair of interference portions 226, 228
spaced from each other by an interference distance 230 sized to
resist back-out of the bone anchor head 232. The interference
portions 226, 228 extend along the retainer 22 a length sufficient
to be disposed above the bone anchor head 232 whether the bone
anchor 18 is at one end of the dynamized bore 14, as indicated by
reference numeral 232 in FIG. 14A, or at the other end of the
dynamized bore 14, as indicated by reference numeral 232' in FIG.
14A. The retainer 22 may also have bone plate engaging portions
240, 242 between the interference portions 226, 228 and the open
end portion 218 that are spaced from each other by a distance 244.
A pair of transverse portions 223, 225 extend inward from the bone
plate engaging portions 240, 242 and are spaced by a distance 227
sized to accommodate a raised portion of the bone anchor head 232
between the transverse portions 223, 225 and the open end portion
218 (see FIG. 9). Like the bone plate engaging portions 219, 221,
the bone plate engaging portions 240, 242 and the open end portion
218 are received within a groove of bore 24 and keep the retainer
22 within the throughbore 14. The positions of the distances 233,
224, 230, 227, and 244 along the retainer 22 are exemplary and not
intended to be limiting. The distances 233, 224, 230, 227, and 244
may generally extend between the respective portions of the
retainer 22 at any position along the length of the respective
portions.
In FIG. 15, the resilient retainer 60 is illustrated with the
approximate position of the bone anchor head 76 within the bore 52
illustrated in dashed lines. The retainer 60 is similar to the
retainer 22 and includes bone plate engaging portions 250, 252,
transverse portions 103, 105, interference portions 94, 95, and
bone plate engaging portions 262, 264, as well as similar
associated distances 258, 268, 270, 272. The clearance distance 268
is sized to provide clearance from the raised portion 107 of the
bone anchor head 76 (see FIG. 4) when the bone anchor head 76 is
seated at an angle within the throughbore 52. One difference
between the retainer 60 and the retainer 60 is that the retainer 22
has a wide, closed end portion 160 and a narrow, open end 150
whereas the ends 216, 218 of the retainer 22 are similarly
sized.
A bone plate system 410 in accordance with another form of the
present invention is shown in FIGS. 16-21. The bone plate system
410 is similar to the bone plate system 10 and includes a bone
plate 412 having a resilient retainer 416 for resisting back-out of
a bone anchor 418 from the bone plate 412. One difference between
the bone plate system 410 and the bone plate system 10 is that the
bone plate 412 includes only non-dynamized pairs of throughbores
413, 414, 415. The bores 413, 415 permit bone anchor insertion
angles in a range of approximately -10.degree. to approximately
20.degree. in the cephalad/caudal plane and a range of
approximately -5.degree. to approximately +5.degree. in the
medial/lateral plane. The pair of throughbores 414 permit bone
anchor insertion angles in a range of approximately -10.degree. to
approximately +10.degree. in the cephalad/caudal plane and a range
of approximately -5.degree. to approximately +5.degree. in the
medial/lateral plane. Further, the bone plate 412 has windows 420
with tool-engaging features 422 for accommodating different shapes
of tools than the windows 62 of the bone plate 12.
Another difference between the bone plate system 410 and the bone
plate system 10 is the shape of the resilient retainer 416. The
resilient retainer 416 is preferably laser cut from sheet stock,
such as Nitinol or titanium sheet stock. The resilient retainer 416
has an expanded configuration that is less expanded than the
retainer 22 (see FIG. 14B) such that the retainer 416 is deflected
a lesser amount to position the retainer 416 within bore 462 of the
bone plate 412. With reference to FIG. 17, the retainer 416
includes bone plate engaging portions 431, 433 shaped to firmly
engage a bore wall 440 (see FIG. 20) of the bone plate 412, as will
be discussed in greater detail below. Transverse portions 432, 434
of the retainer 416 extend inward from the bone plate engaging
portions 431, 433 toward interference portions 442, 444 which each
include a straight 446, 448. With reference to FIGS. 18 and 19, the
retainer 416 is shown disposed above the bone anchor 418 in a
throughbore 462 of the pair of non-dynamized throughbores 413. The
bore wall 440 defines a groove 464 shaped to accommodate a
rectangular cross-section of the retainer 416, as shown in FIG. 18.
When the bone anchor 418 is driven into the bore 462 at an angle in
the cephalad/caudal plane and a head 466 of the bone anchor 418 is
seated within the bore 462, the retainer interference portion 442
overlaps the head 466 of the bone anchor 418 to resist back-out, as
shown in FIG. 19. Further, the retainer transverse portion 432
extends radially outward toward the groove 464 and is generally out
of the way of the bone anchor head 466 seated within the
throughbore 462.
With respect to FIGS. 20 and 21, the bore wall 440 includes a
plurality of walls sized to compliment the outer profile of the
resilient retainer 416 and resist rotation of the retainer 416
during installation of the bone anchor 418. More specifically, the
bore wall 440 includes an end wall 480 and opposite side walls 482,
484 separated from transverse end walls 486, 488 by corners 490,
492. With the retainer 416 disposed within the groove 464, as shown
in FIG. 21, spaced ends 494, 496 of the retainer 416 extend along
the end wall 480 with a complimentary curvature until reaching the
straights 446, 448 at which point the retainer 416 extends away
from the opposite side walls 482, 484. The retainer 416 also
includes elbows 498, 500 disposed between transverse portions 432,
434 and bone plate engaging portions 431, 433 that firmly engage
opposite side walls 482, 484 and resist rotation of the retainer
416 as the bone anchor 418 is rotated within the throughbore 462 in
directions 502, 504, respectively.
A bone plate system 610 in accordance with another form of the
present invention is shown in FIGS. 22-26. The bone plate system
610 is similar to the bone plate systems 10, 410 and comprises a
bone plate 612 having a resilient retainer 614 for resisting
back-out of a bone screw 616 from a throughbore 618 of the bone
plate 612. Unlike the bone plate systems 10, 410, the bone plate
system 610 includes a tab recess 620 in communication with the
throughbore 618 for receiving a tab 622 of the associated retainer
614. As shown in FIGS. 23 and 24, the bone plate 612 includes a
bore wall 630 which defines the tab recess 620 in a transverse end
wall 632 of the throughbore 618.
As shown in FIG. 23, the bone plate 612 has a spherical throughbore
seat 621 extending around the throughbore 618. Unlike the seats of
throughbores 60 and 462, the seat 621 has a continuous seating
surface 623 extending around the entire throughbore 618. The seat
621 does, however, have a narrow portion 625 and a wide portion 627
for engaging a head 629 of the bone anchor 616.
Another difference between the bone plate system 610 and the bone
plate systems 10, 410 is that the retainer 614 has a wide, open end
portion 634 with a pair of spaced ends 636, 638 adjacent a pair of
transverse portions 640, 642 and a narrow, closed end portion 644
adjacent a pair of interference portions 646, 648. By contrast, the
narrow open end portions 150, 450 of the retainers 60, 430 are
adjacent their respective interference portions 94, 95 and 442,
444.
Turning to FIGS. 25 and 26, further details of the retainer 614 are
disclosed. The retainer 614 generally has a pair of arms 651, 653
with the transverse portions 640, 642 and the interference portions
646, 648 extending therealong. The arms 651, 653 generally have a
uniform width 652 in the range of approximately 0.01 inches to
approximately 0.03 inches, preferably approximately 0.02 inches.
The retainer 614 includes bone plate engaging portions 654, 656
having a generally straight configuration extending along axes 658,
660 that are disposed at an angle .gamma. relative to one another
in the range of approximately 60.degree. to approximately
120.degree., preferably approximately 90.degree.. The transverse
portions 640, 642 may have an outer radius 672 in the range of
approximately 0.04 inches to approximately 0.07 inches, preferably
approximately 0.055 inches, and an inner radius 670 in the range of
approximately 0.02 inches to approximately 0.05 inches, preferably
approximately 0.035 inches. Further, the transverse portions 640,
642 may extend at an angle 669 relative to one another, the angle
669 being in the range of approximately 60.degree. to approximately
90.degree. , preferably 78.degree..
The transverse portions 640, 642 may be separated by a distance 674
in the range of approximately 0.15 inches to approximately 0.22
inches, preferably approximately 0.185 inches. The retainer 614 may
have bone plate engaging portions 676, 678 adjacent the
interference portions 646, 648, the bone plate engaging portions
676, 678 having an inner radius 680 in the range of approximately
0.05 inches to approximately 0.08 inches, preferably approximately
0.065 inches. The bone plate engaging portions 676, 678 may also
have an outer radius 682 in the range of approximately 0.07 inches
to approximately 0.10 inches, preferably approximately 0.085
inches. The interference portions 646, 648 of the retainer 614 may
have an outer width 684 in the range of approximately 0.18 inches
to approximately 0.27 inches, preferably approximately 0.225
inches. Similarly, the bone plate engaging portions 654, 656 may
have an outer width 686 in the range of approximately 0.21 inches
to approximately 0.32 inches, preferably approximately 0.265
inches. The retainer 614 may have points 690, 692 representing the
centers of the radius of curvature of the bone plate engaging
portion 656 and the bone plate engaging portion 678. The retainer
614 may have a distance 688 between the points 690, 692 in the
range of approximately 0.08 inches to approximately 0.13 inches,
preferably approximately 0.108 inches. In another aspect, the
retainer 614 has a distance 694 between ends of the bone plate
engaging portions 654, 656 and an inner surface 693 of the closed
end portion 644. The distance 694 may be in the range of
approximately 0.23 inches to approximately 0.34 inches, preferably
approximately 0.288 inches. Further, the retainer 614 may have a
distance 696 between the inner surface 693 of the closed end
portion 644 and an outermost point of the tab 622. The distance 696
may be in the range of approximately 0.02 inches to approximately
0.07 inches, preferably approximately 0.05 inches. With reference
to FIG. 26, the retainer 614 may have a thickness 698 in the range
of approximately 0.015 inches to approximately 0.025 inches,
preferably approximately 0.02 inches.
While preferred embodiments of the present invention have been
shown and described herein, it will be obvious to those skilled in
the art that such embodiments are provided by way of example only.
Numerous variations, changes, and substitutions will now occur to
those skilled in the art without departing from the invention. It
should be understood that various alternatives to the embodiments
of the invention described herein may be employed in practicing the
invention. It is intended that the following claims define the
scope of the invention and that methods and structures within the
scope of these claims and their equivalents be covered thereby.
* * * * *
References